Research progress on the correlation between anti-citrullinated peptide/protein antibodies and bone erosion in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease primarily affecting the synovial joints, characterized by progressive destruction of bone and cartilage tissue and the production of various autoantibodies. Anti-citrullinated peptide/protein antibodies (ACPA) are one of the autoantibodies found in RA patients, exhibiting high specificity and playing a significant role in the early diagnosis, disease assessment, and prognosis prediction. Over the years, ACPA has been considered a pathogenic autoantibody in RA, closely associated with bone destruction and participating in osteoclast activation through both direct and indirect mechanisms. Recent studies, however, have found that certain monoclonal ACPAs can suppress osteoclastogenesis and show protective effects in murine experimental arthritis models. This suggests a complex role for ACPA in the development of bone erosion in RA. This review will summarize the research progress on the correlation between ACPA and bone erosion in RA.